| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $27.43 | |
Aetna
| Professional | $10.58 | $10.58 | $20.00 | |
Cigna
| Facility | $45.39 | $45.39 | $45.39 | |
Cigna
| Professional | $19.00 | $19.00 | $23.75 | |
Regence BlueShield
| Facility | $82.20 | $103.83 | $149.72 |